PDA and AVSD Flashcards
1
Q
What is a PDA associated with?
A
- Preterm infants
- Maternal warfarin and phenytoin
- Congenital Rubella
- girls>boys
2
Q
Common findings on history with PDA?
A
- Small PDAs asymptomatic
- Large shunt- LRTIs, atelectasis, CHF with FTT
- Exertional dyspnoea in kids with large shunt PDA
3
Q
Examination findings of PDA?
A
- Tachycardia and tachypnoea with CHF
- Bounding peripheral pulse with wide PP in large PDA (waterhammer)
- Hyperactive precordium with systolic thrill if PHTN
- Grade 1-4/6 continuous ‘machinery’ murmur left infraclav
- If PHTN, a R->L shunt and cyanosis in lower body
4
Q
ECG findings in PDA?
A
Similar to VSD
- May show LVH/BVH
- RVH if PHTN
5
Q
CXR findings in PDA?
A
Similar to VSD
- May be normal
- Cardiomegaly of varying degrees involving ascending aorta
- Increased pulmonary vascular markings
- If Pulmon vascular disease, heart size normalizes –> PA prominence
6
Q
What is the difference between PDA at full term vs pre term?
A
FT- Rarely closes spontaneously. Due to structural abnormality rather than decreased responsiveness of ductal smooth muscle to oxygen.
7
Q
What are some differentials of continuous heart murmur or bounding pulse?
A
- AV fistulas- Coronary/pulmonary/systemic
- Venous hum- infraclavs bilaterally, disappear when supine
- Collaterals in COA- intercostal spaces bilaterally
- VSD with AR- to a fro murmur
- Persistent truncus arteriousis
8
Q
What is medical management of PDA in term infants?
A
- Non surgical closure
9
Q
Is Ductus proximal or distal to the left subclavian?
A
5-10mm distal
